Organization
MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CONERTY RPH (OWNER PHARMACIST)
(732) 367-5080
Entity
Organization
Contact information
Practice address
681 RIVER AVE, LAKEWOOD, NJ 08701-5229
(732) 367-5080
(732) 367-5734
Mailing address
681 RIVER AVE, LAKEWOOD, NJ 08701-5229
(732) 367-5080
(732) 367-5734
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RS00614000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3120627
OTHER ID NUMBER
—
05
—
9004408
—
NJ
Enumeration date
08/03/2006
Last updated
03/07/2023
Update your record
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